Pancreaticobiliary maljunction and congenital choledochal cyst

Objective To investigate the possible mechanism of pancreaticobiliary maljunction(PBM) on development of congenital choledochal cyst(CCC).Methods Tweenty-one patients with choledochal cysts initially diagnosed by ultrasonography,then underwent ERCP.The concentrations of amylase(AMS) and C-reactive protein(CRP) in bile removed through selective biliary catheterization was analyzed.Results Each of 21 cases of PBM(including 13 cases of C-P type and 8 cases of P-C type) had significantly higher concentrations of AMS and CRP compared with control group(P0.01).The elevations of AMS and CRP in C-P type were much higher than those in P-C type.(P0.05).Conclusions PBM was likely the anatomic foundation of CCC formation.However,the activated,highly concentrated pancreatic enzymes resulting from pancreatic juice reflux into the bile ducts can cause injury of the walls of bile ducts,and trigger CCC formation.